Heart failure & cardiomyopathiesCohort study
Associations between cardiac resynchronization therapy and clinical outcomes according to the atrial fibrillation status in patients with heart failure with reduced ejection fraction
- Registry-based cohort study
- Swedish Heart Failure (HF) Registry
Authors' conclusion
A diagnosis of AF was not associated with the likelihood of receiving CRT in real-world HF care, nor did it affect the association between CRT and lower risk of clinical outcomes.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) meeting the guidelines' recommendation for cardiac resynchronization therapy (CRT), Swedish HF Registry, 2014–202224.7% received CRT
- Participants
- 3,530 patients
- Exposure
- CRT vs no CRT, according to atrial fibrillation (AF) status
- Outcome
- Composite of:
- Time to first HF hospitalization
- Cardiovascular (CV) death
Main finding
CV death/first HF hospitalization
Hazard ratio
0.71
95% CI 0.64–0.79
CRT vs No CRT
HR 0.71 (95% CI 0.64–0.79)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause death · regardless of AF | 0.72 (0.64–0.81) | |
| 0.512Hazard ratio (log scale) |
Individual components of the primary endpoint; total HF hospitalizations
- CRT associated with lower adjusted risk of each component, but not with total number of HF hospitalizations
Likelihood of receiving CRT by AF (AF in 51.6%)
- AF not associated with the likelihood of receiving a CRT
Original publication
Associations between cardiac resynchronization therapy and clinical outcomes according to the atrial fibrillation status in patients with heart failure with reduced ejection fraction. Europace. Published 18 November 2025. doi:10.1093/europace/euaf296
Summarised from the published abstract; every number is checked against it